VI. Imiphumela yokuncipha kokushisa komzimba kwe-intraperative
(I) imiphumela ohlelweni lwenhliziyo
(Ii) imiphumela ekubumbeni
Umsebenzi we-platelet owenziwe buthaka wehlisa umsebenzi wokugcina unciphise umsebenzi, okuholela ngesikhathi sokudonsa isikhathi eside nokwandisa inani lokopha. Izinga lokushisa eliphansi libuye liholele ekugqekezweni kwegazi ekugxileni kwegazi emithanjeni, okungadala kalula i-vein thrombosis ejulile.
Izinga lokushisa lomzimba lingaphansi kwama-35 ° C, izinkomba ezilandelayo zihlala isikhathi eside ngokushisa kwalezi zinkomba ezilandelayo ziye zande kakhulu ngokushisa okunciphayo:
Isikhathi se-prothrombin esenziwe ngokwengxenye (aptt)
Isikhathi se-Prothrombin (PT)
Isikhathi se-prothrombin (TT)
(Iii) Izifo ezengeziwe zokufaka
Amazinga okushisa omzimba aphansi angalimaza ngokuqondile umsebenzi wokuzivikela, anciphise ukulethwa komoya-mpilo wegazi esikhunjeni, kanye namaprotheni kanye nokuhlanganiswa kwe-glial; Ngasikhathi sinye, ukuphakama okumpofu kwezicubu ze-peri-inclusional futhi kubambezele ukuphulukiswa kwe-incision okubambezelekile kuholela ekutheni isilinganiso esandayo sesilinganiso sokutheleleka isilonda siyanda.
Amazinga okushisa ahlanganyele ngaphansi kwama-35 ° C ahlotshaniswa nokukhuphuka okungamampunge okuthelelekile ekuthelelekeni ngamanxeba kanye nokuhlala esibhedlela okungu-20%.
Kukhishwe kusuka ku: Zhang Y. Ukunakekelwa kwe-hypothermia [J]. I-XINJIANG Chinese Medicine, 2011.29 (04) .92-94..
(Iv) Ukuvuka okubambezelekile
-Decrease aflow flow e-hypothermia
Umsebenzi wesibindi we -decrease
-I-Renal Plow Flow ne-Glomerular Filtration Rate
-I-Metabolism yezidakamizwa
I-hypothermia ivimbela umsebenzi wezinzwa onozwela futhi inciphisa ukukhiqizwa kwe-catecholamine, okwenza buthaka impendulo yomzimba kwisikhuthazo sangaphandle, kanti ama-anesthetics ahlanzwa emzimbeni ngesilinganiso esikahle, okuholela ekuvuseleleni isikhathi eside.
(V) ukuphazamiseka kwe-metabolic
Kuthinta i-metabolism yomzimba
-Izimpawu ze-nerve
-Acidosis, i-electrolyte imbalince
-Ukungasebenzi kwe -Immune
Ukusetshenziswa komzimba komoya-oxygen
-Changes endaweni yangaphakathi
I-hypothermia yehlisa izinga le-metabolic yomzimba, futhi kuwo wonke amazinga okushisa omzimba aphansi we-1c, izinga le-metabolic lincishiswa ngo-6%. Ekushiseni komzimba kwe-28C, izinga le-metabolic lingama-50% okujwayelekile.
Kukhishwe kusuka ku: Yu Dingning, Li Dunyo, ingozi ye-hypothermia kanye nokwelashwa kwayo [j]. Umuthi waphesheya: Ukuhlinzwa Kwangaphandle Kwemithi: Ukuhlinzwa, 2004,31 (5): 258-261.
Vii.methods wokuthola izinga lokushisa lomzimba ngesikhathi sokuhlinzwa
Eqinisweni, umehluko phakathi kwamazinga okushisa aphakathi nendawo nasemzimbeni kunzima ukulinganisa ngaphandle kobudlelwano obuqondile, ngakho-ke kunconywa ukusebenzisa umdwebo womzimba wokuqapha ukuze uthole ngokunembile lokushisa lomzimba lapho kuvunyelwe
Viii.priount of perioperative hypothermia nokunakekelwa
(I) ukungenelela kokunakekelwa kwengqondo
Ukuvakasha kwangaphambi kokusebenza (ukuhlolwa):
Ngokuvakasha okusekelwa ekuhambeleni, isimo sesiguli sihlola kahle, senza ukuxilongwa kwabahlengikazi, bahlongoza uhlelo lwabahlengikazi, yenza ukulungiswa okwanele, futhi basebenzise izindlela zokufudumala ngosuku lokuhlinzwa ukuze
vimbela i-hypothermia.
Ngasikhathi sinye, ngokuvakasha okubangela ukuvakasha, wandise ukujwayela umhlengikazi, okulungele ukuxhumana okungcono phakathi kwabahlengikazi neziguli. Ukuqashelwa, okulungele ukuxhumana okungcono phakathi kweziguli nabahlengikazi futhi kunciphise ukwethuka kweziguli. ukwethuka kweziguli nokwehlisa umkhawulo wabo wokukhuthaza okubandayo. Umkhawulo wesiguli wokukhuthaza ukubanda uzokwehliswa.
(Ii) izinga lokushisa kwezemvelo
Ukushisa kwegumbi elilawulwa ngamandla 21-25 ° C. Ukugcina umswakama ngo-30-60%
Ukugcina izinga lokushisa elifanele kanye nomswakama kunganciphisa ukulahleka kokushisa kusuka esikhunjeni futhi kuyindlela ephumelelayo yokuvikela i-hypothermia.
Izinga lokushisa kanye nomswakama wegumbi lokusebenza lilawulwa yiCentral Air conditioner, izinga lokushisa lekamelo lizoshintshwa libe ngu-25 ° C ngaphambi kokuqala kokusebenza kwesiguli, futhi kuphela ngemuva kokuqala kokusebenza kuzolungiswa ku-21-23 ° C. Kuqinisekisiwe ukuthi isiguli ngeke sithintwe yimvelo ethinta ushintsho lokushisa komzimba.
(Iii) ukufudumala koketshezi
A. Ukufakwa uketshezi olufudunyezwa ku-37 ° C:
Usawoti noma amanzi omjovo asetshenziselwa ukukhulula isikhumba nokuhlanza kubekwa ku-thermostat futhi kulungiswe ku-37 ° C. Yikhiphe e-thermostat ngaphambi kokusebenzisa ukunciphisa ukulahleka kokushisa komzimba.
B. Ukusetshenziswa kokumila okufudumele ngesikhathi sokumpompela igazi:
Lapho senza inani elikhulu lokumpompela igazi, kuzosetshenziswa idivaysi yokufudumeza yegazi ukuqinisekisa ukuthi uketshezi olufakwe emzimbeni wesiguli lusondele ekushiseni komzimba wesiguli.
(Iv) Sebenzisa imishini yokufakelwa
Ingubo emnene evuthayo isetshenziselwa ukumboza indawo engahlimisi, esebenzisa izinga lokushisa elithile emzimbeni wokushisa kwegesi ephezulu ye-convection, futhi idlale indawo yokushisa emzimbeni yokwehlukanisa umzimba kanye nendawo ebandayo ezungezile, ukufudumala isikhumba esisebenzayo.
(V) isikhathi sokuvezwa kokuvezwa kwesikhundla sokushintsha
A.Develop An A.Develop a in inqubo esezingeni elifanele ukunciphisa isikhathi sokuvezwa kwezinguquko zesikhundla
B.Poposition ngezikhundla ezikhethekile zokuhlinzwa
Ama-Orthopedics: Isikhundla Sokuvuselela
I-thoracic: isikhundla sokulala eceleni
I-Urology: Isikhundla se-Side-Ling
I-LithoTomy
(Vi) Ukuvimbela amanzi
Gwema noma unciphise ukufaka amashidi.
Mboza ishidi eliyinyumba ngesendlalelo sesikhwama sepulasitiki (uma nje kungangcolise futhi kuthinte insimu yokuhlinza).
Vimbela ukugcobhozela ngelineni lesiguli nelilo lokulala elinamanani amakhulu ezinhlobo zokuhlinzwa.
Okokuhlinzwa okudinga inani elikhulu lamanzi amakhabe aphelile, njengokuhlinzwa kwe-urological (i-percutate efleriotomy, njll. Ukwelashwa komdlavuza wamathumbu (ukuthengiswa kwesibindi, njll.
Isifinyezo:
Into ye-hypothermia ye-intraperouperative aperaperate idonsela ukunaka kwabasebenzi bakwa-Clinical ngokusebenzisa indawo yomzimba elawulwayo kanye nokuhlinzwa okuhlinzayo komzimba ngaphambi nangemva kokuthola imvelo ye-hypothermia eforale ngempumelelo ezigulini. Yehlisiwe kunganciphisa izinkinga eziningi ezibangelwa yi-hypothermia, kunciphise izinhlungu zeziguli, futhi kunciphise izindleko zezokwelapha zeziguli, ezilungele ukululama kwangaphambi kwesikhathi.
Isixhumanisi Sangaphambilini Isixhumanisi: https://www.mecanmedical.com/prevention-care-care-of-intraoperative-hypTothermia-part---61252817.html
